Recognize Parkinson's disease early and successfully treat it

Recognize and treat Parkinson's disease early
Parkinson's is incurable to this day. The causes are still poorly scientifically researched. The neurologist Prof. Daniela Berg from the University Medical Center Schleswig-Holstein reports at the annual congress of the German Society of Neurology (DGN) in Leipzig about the latest advances and possible approaches in therapy. What is new is that Parkinson's makes itself felt by some early symptoms and thus an early therapy would be possible. For example, sleep disorders are one of them. However, the cause of a disturbed sleep can be versatile. Therefore, the early complaints are too unspecific and diverse.

"There is not just one Parkinson's disease - there are many," says Prof. Daniela Berg at the opening of the DGN Annual Congress in Leipzig. The neurologist is in recent studies on the possible different triggers of Parkinson's disease on the track, with both the genes and environmental factors are the focus of their research. The hope is that determining the causes at the earliest possible stage will help those affected better in the future, reports the German Neurological Society.

Numerous early signs of Parkinson's. Picture: eyeQ-fotolia

400,000 Parkinson's patients in Germany
At the beginning of the annual congress of the DGN, Prof. Berg presented the latest scientific findings on the causes of the disease and discussed how Parkinson's patients can benefit from it. According to the DGN, more than 400,000 people in this country are affected by Parkinson's, with a slowing of movement, small-step gait, speech disorders, tremors and stiffness are considered typical signs of the disease. Further evidence of an incipient Parkinson's disease are "abnormalities of movement such as the reduced swinging of an arm while walking, disorders of fine motor skills or a changed typeface," according to the DGN.

Parkison signs sometimes unspecific
With a striking tremor of the limbs, especially many older people think directly of Parkinson's disease. But "not every tremor means Parkinson's", emphasizes Prof. Berg. In fact, the majority of people who shiver have no Parkinson's. If, in addition to abnormalities of the movement other symptoms such as reduced odor perception, a dream sleep disorder, changes in urination, constipation or depression, but these may be important clues for an early diagnosis, the expert explains.

Unspecific symptoms complicate the diagnosis
While many of the symptoms "seemingly have nothing to do with what is widely understood as Parkinson's," they may "indicate the presence of Parkinson's disease," emphasizes Prof. Berg. Since the symptoms are so unspecific, the suspicion is often not Parkinson's and it takes many years until the disease is detected. The cause of these nonspecific symptoms is the fact that Parkinson's disease gradually spreads over the years throughout the nervous system.

Parkinson's develops in the digestive tract?
According to Prof. Berg, "new studies support the hypothesis that Parkinson's disease develops in the stomach / intestine and migrates via the nerve tracts to the brain." A key role is played by the misfolded protein molecule alpha-synuclein, which is deposited in the diseased nerve cells. If nerve cells suffer from Parkinson's, they can, so to speak, infect other nerve cells, the neurologist continues. The disease-typical deposits of alpha-synuclein are also detected outside the brain, such as in the gut, in the salivary glands or in the skin.

Detect Parkinson's from skin samples
Furthermore, a recently published "study by Marburg and Würzburg neuroscientists in high-risk patients, the disease already before the onset of motor symptoms on a skin sample detect," says the DGN. The test identified Parkinson's patients as identifiable at an early stage and could be offered to participate in clinical trials to determine how disease progression can be prevented.

Disease at the time of diagnosis often already advanced
So far, the dilemma of Parkinson's diagnosis is that at the onset of the first motor symptoms already more than 50 percent of the dopaminergic neurons in the midbrain have died, said the DGN. The disease process then run for years to decades. On the basis of the specific constellation of movement abnormalities and non-motor symptoms, however, it would be possible to recognize the disease much earlier. "Anyone who detects subtle changes in his arm movement, fine motor skills or typefaces should be able to undergo neurological examination," recommends the expert.

Early diagnosis crucial for treatment options
According to the DGN, early diagnosis has far-reaching consequences for therapy. Because recent research would show that patients in the initial phase of the disease benefit from a therapy with dopamine or dopamine-like substances. At the time of the diagnosis, however, there has often been a considerable shortage of the messenger substance dopamine for a long time, which the brain can only compensate for a certain period of time. Here, "therapeutic dopamine relieves the brain, helps it - like oil in an engine - to work regularly, which contributes to a better mobility," explains Prof. Berg.

New approaches to treating Parkinson's disease
On the basis of the therapies available today, Parkinson's patients, even after many years of illness, are generally less restricted than they were 15 to 20 years ago, reports the neurologist. In addition, in centers that deal with the research and therapy of Parkinson's disease, for the first time in the context of studies and therapeutic approaches are available to attack the causes of neuronal cell death and prevent the spread of the disease process on healthy nerve cells, the expert said continue. These are, for example, studies of familial, inheritable forms of Parkinson's disease and vaccination studies. The approach of a "Parkinson's vaccine" based on an antibody to the protein alpha-synuclein, which could stifle the spread of the disease in the bud.

Possibilities of own influence
Not least increase, according to the expert, the evidence that even the patients themselves can have a positive influence on the disease process. So lifestyle factors such as sufficient physical activity and the consumption of vitamin and polyphenolhaltigen foods such as coffee, green / black tea or red berries are helpful. The implementation of these findings could also be important for prevention. For example, several studies have clearly shown that people with lower incidence of Parkinson's disease in old age experience adequate physical activity as of middle age. (Fp)